STEPHANIE E. DELUCA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000928

License Status

EXPIRED

Business

First Name

STEPHANIE

Middle

Last Name

DELUCA

Business Name

STEPHANIE E. DELUCA

Original Issue Date

04/01/2021

Effective Date

04/01/2021

Expiration Date

09/30/2021

City

MEDFORD

State

Zip

02155

County

MASSACHUSETTS

Specialty/Qualifier

Pediatric Sports Medicine

Ever Disciplined

LastModifiedDate

10/11/2022